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Development and usability evaluation of an electronic health report form to assess health in young people: a mixed-methods approach
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare. Clinic for Pain Rehabilitation Västmanland, Region Västmanland, Västerås, Sweden; Centre for Innovation, Research and Education, Region Västmanland, Vastmanland Hospital, Västerås, Sweden.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-5566-3421
Centre for Clinical Research, Region Västmanland – Uppsala University, Region Vastmanland, Västerås, Sweden.
Mälardalen University, School of Health, Care and Social Welfare, Health and Welfare.ORCID iD: 0000-0002-4537-030X
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2023 (English)In: BMC Medical Informatics and Decision Making, E-ISSN 1472-6947, Vol. 23, no 1, article id 91Article in journal (Refereed) Published
Abstract [en]

Background: Electronic Patient-Reported Outcomes (ePROs) have potential to improve health outcomes and healthcare. The development of health-technology applications, such as ePROs, should include the potential users and be theoretically grounded. Swedish Youth Health Clinics (YHCs) offer primarily sexual and psychological healthcare for young people aged 12 to 25 years old. Young people in healthcare settings are considered a vulnerable group. The development of a collection of Patient-Reported Outcomes (PROs) in an Electronic Health Report Form (eHRF) for identifying health and health-related problems in young people, was preceded by a qualitative interview study, exploring young people’s views on using an eHRF at YHCs and which questions about health an eHRF should contain. The aim of the current study was to develop and evaluate the usability of an eHRF prototype for identifying health and health-related problems in young people visiting YHCs. Methods: This study used a participatory design. During the development, an expert panel consisting of eight researchers and one Information Technology worker, participated. A wide literature search was performed to find PROs to construct an eHRF prototype to cover health areas. A mixed methods usability evaluation included 14 participants (young people, healthcare professionals, and an expert panel). Results: The development resulted in an eHRF prototype, containing ten reliable and valid health questionnaires addressing mental-, physical-, and sexual health and social support, a self-efficacy question, and background questions, in total 74 items. The interviews in the usability evaluation resulted in three categories describing the usability of the eHRF: ‘Captures the overall health of young people but needs clarification’, ‘Fun, easy, and optional and will keep young people’s interest’, and ‘Potential contribution to improve the health consultation’. The quantitative results support the usability of the eHRF for YHCs. Conclusions: The participatory approach contributed to development of the eHRF prototype to cover health areas adapted for the target population. The usability evaluation showed that the eHRF was usable and had the potential for self-reflection and contributions to cooperation between young people and healthcare professionals during the health consultation.

Place, publisher, year, edition, pages
BioMed Central Ltd , 2023. Vol. 23, no 1, article id 91
Keywords [en]
Developmental study, Electronic patient-reported outcome, Medical informatics, Mixed methods research, Participatory research, Usability study, Young people, Youth health clinic, adolescent, article, clinical article, consultation, controlled study, female, health center, human, information technology, interview, juvenile, male, outcome assessment, patient-reported outcome, questionnaire, self concept, sexual health, social support, usability, worker
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:mdh:diva-62588DOI: 10.1186/s12911-023-02191-7ISI: 000984814800002PubMedID: 37165371Scopus ID: 2-s2.0-85158839793OAI: oai:DiVA.org:mdh-62588DiVA, id: diva2:1760568
Available from: 2023-05-30 Created: 2023-05-30 Last updated: 2023-08-31Bibliographically approved
In thesis
1. Development of a digital Health Report System: From exploration of need to identification of health-related problems in young people
Open this publication in new window or tab >>Development of a digital Health Report System: From exploration of need to identification of health-related problems in young people
2023 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Introduction While foremost mental health and psychosomatic symptoms are increasing in young people, little is known about the health in young people visiting Youth Health Clinics (YHC). Also, there is no unified health survey used to collect overall health data from young people nationally at YHCs.

Aims To develop a health- and welfare technology tool to identify and increase knowledge about health-related problems in young people visiting YHCs.

Methods The structured development of a health and welfare technology tool, the Health Report System (studies I to III) had a consultative level participatory approach. Study I was qualitative and contained interviews with young people on content and design for a digital questionnaire. Studies II and III had mixed methods design and included young people, healthcare professionals, and a researcher expert panel. Qualitative data came from interviews and quantitative data from questionnaires. The studies evaluated usability and feasibility. Study IV was quantitative and used data from the evaluation questionnaire, exploring the mediated association of variables on mental well-being, using a set of regression analyses.

Results Study I: Young people (n=15) were positive to use a health and welfare technology tool if it was in accordance with their needs. It should give an overview of mental-, physical-, and sexual health and social support. The results should be discussed with healthcare professionals during a health assessment. Study II: The researchers used guidelines to develop the Health Report System and included ten validated and reliable health questionnaires. The usability of the Health Report System was evaluated by young people (n=4), YHC healthcare professionals (n=3), and an expert panel (n=7). The converged qualitative and quantitative data showed that the Health Report System was very usable for YHCs. Study III: The qualitative results from healthcare professionals’ interviews (n=11) and quantitative questionnaire results from young people (n=54) were merged. Using a matrix for assessment of feasibility, the researcher's consensus decision, was that progression and use of the Health Report System in an intervention study was feasible. Study IV: Results from young people’s (n=223) health data showed statistical significance for the mediating effect of social functioning between the sense of mastery and mental well-being. 

Conclusion This thesis presents that the Health Report System has the potential to identify health-related problems in young people, strengthen the health communication between young people and healthcare professionals, and influence the YHC organization. 

Place, publisher, year, edition, pages
Västerås: Mälardalens universitet, 2023. p. 92
Series
Mälardalen University Press Dissertations, ISSN 1651-4238 ; 386
National Category
Physiotherapy
Research subject
Physiotherapy
Identifiers
urn:nbn:se:mdh:diva-64138 (URN)978-91-7485-606-4 (ISBN)
Public defence
2023-10-27, Lambda och digitalt via Zoom, Mälardalens universitet, Västerås, 09:15 (English)
Opponent
Supervisors
Funder
Region Västmanland, LTV-939219
Available from: 2023-08-31 Created: 2023-08-31 Last updated: 2023-10-06Bibliographically approved

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Mattebo, MagdalenaSöderlund, AnneRevenäs, Åsa

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